Intended for healthcare professionals

Rapid response to:


Rectal artemether versus intravenous quinine for the treatment of cerebral malaria in children in Uganda: randomised clinical trial

BMJ 2005; 330 doi: (Published 10 February 2005) Cite this as: BMJ 2005;330:334

Rapid Response:

Another evidence why the firstline drugs should be changed!

To begin with, I congratulate Dr(s) Aceng R, Byarugaba J & Prof Tumwine upen continuely maintaining a forward fight against one of the most deadlest killers of children in subsaharan Africa, AIDS aside.

Following the decision by the MoH, Uganda, together with its WHO partners to change the firstline treatment of Malaria from the SP/CQ combination to Artemesin Combination Therapy (ART),there is no doubt that more research needs to be done in the direction of ACTs--and this is but one.

As a medical person leaving in Uganda, I have personally fallen ill over several occasions from malaria, but the thought of taking SP/CQ or quinine breaks my heart--the side effects are dreadful. For instance, there was a time when the pruritis from the CQ could keep me indoors for fear of being seen scratch myself in rare perineal areas (not that we all aint gat them). So after this ACTs advent, I have always had objections to prescibing SP/CQ or quinine to any of my patients.

So should the rights of these infants that cant complain be honored, and my advice to the Ugandan ministry of Health would be (glancing at these results) to rush to make this a policy--RECTAL ARTEMETHER for severe malaria in children.

Competing interests: None declared

Competing interests: No competing interests

16 February 2005
Dr. Wayengera Misaki
Mulago National Refferal Hospital,Uganda